allergic rhinitis Flashcards
most common type of rhinitis
allergic rhinitis
sx of allergic rhinitis (5)
congestion
malaise
clear drainage
SNEEZING
red itchy eyes
how long do sx of allergic rhinitis
weeks at a time
viral vs allergic rhinitis
viral– erythematous (beefy red) turbinates
allergic– edematous, pale or violet boggy turbinates; nasal polyps w/ cobblestone mucosa
inflammation of nasal cavity mucosa?
rhinitis
inflammation of both nose and sinuses?
rhinosinusitis
infection caused by sinus ostia obstruction
sinusitis
catarrhal inflammation of the mucous membrane in the nose, caused especially by a cold or by hay fever
coryza
what causes allergic rhinitis
Type 1 hypersensitivity rxn– IgE mediated mast cell histamine release d/t allergens
3 medications related to non-allergic rhinits
CPAP
beta blocker (-lol)
ace inhibitor (-pril)
2 endocrine issues related to non-allergic rhinitis
hypothyroidism, pregnancy
3 types of rhinitis
seasonal allergic (grass, tree)
perenial allergic (dust mite, mold, dander)
non-allergic (irritant, medication)
3 key PE signs suspicious for bacterial sinusitis
persistent sx 10+ days (fails to improve by day 10)
severe sx 3+ days
double worsening sx 3+ days
what is double worsening
when sx worsen w/in 10 days after initially getting better
when should you get CT scan?
for sinusitis complications
confirm chronic sinusitis
PE of bacterial vs viral (what you see inside the nose)
bacterial– erythema or edema; PURULENT drainage WITHIN the nose or posterior pharynx
viral– erythematous, engorged nasal mucosa w/o intranasal purulence
non-allergic inflammation of nasal tissues causing paroxysmal sneezing, nasal congestion, excessive runny nose or post nasal drip
vasomotor rhinitis
signs of vasomotor rhinitis
nasal mucosa over turbinates is congested and hypertrophic
tx of vasomotor rhinitis (4)
avoid triggers
antihistamines & oral decongestants
topical & systemic steroids
surgery
rebound phenomenon after excessive use of decongestant nasal drops after 3 consecutive days of use
rhinitis medicamentosa (RM)
what causes nasal polyps
mostly allergic rhinitis
also cystic fibrosis
nasal polyps on PE
on direct visualization, you see pale boggy mass on nasal mucosa
tx of nasal polyps (2)
1 intranasal corticosteroids
may need surgery
inflammation for 12+ consecutive weeks
chronic sinusitis
most likely cause of chronic sinusitis
fungal– aspergillus or mucormycosis
how is chronic sinusitis diagnosed?
biopsy or histology
when should you recommend topical steroids for allergic rhinitis? what if its not adequate?
if sx affect quality of life
if inadequate, can add intranasal antihistamine
3 things to tx symptoms of allergic rhinitis
topical nasal steroid (mometasone)
oral antihistamine
saline irrigation
